Sleep Deprivation & Debt
SHC likes the National Heart, Lung and Blood Institute (NHLBI)’s simple, obvious definition of sleep deprivation:
“Sleep deprivation is a condition that occurs if you don’t get enough sleep.”
Seems simple enough. To be clear, we’re not talking about sleep deprivation as an active form of psychological torture here. We’re talking about lost, poor sleep and the hazards it wages against our bodies and minds as a result.
The NHLBI further discusses sleep deprivation from the wider lens of sleep deficiency:
“Sleep deficiency is a broader concept. It occurs if you have one or more of the following:
You don’t get enough sleep (sleep deprivation)
You sleep at the wrong time of day (that is, you’re out of sync with your body’s natural clock)
You don’t sleep well or get all of the different types of sleep that your body needs
You have a sleep disorder that prevents you from getting enough sleep or causes poor quality sleep”
What the NHLBI introduces is actually a handful of terms—sleep deprivation, sleep deficiency, poor sleep—which more or less reference the same concern: a person who is sleep deprived is not getting enough sleep.
(Allow SHC to add to this list of terms: sleep debt, insufficient sleep, inadequate sleep, sleep deficit.)
How much sleep do we need?
Good question. You can’t know if you’re not getting enough if you don’t know how much you should be getting, to begin with!
Everyone is going to vary a little on the scale of sleep need. But the National Sleep Foundation (NSF)‘s most recent recommendations for adequate sleep provide ranges for different age groups.
- Newborns (0-3 mos): 14-17 hours
- Infants (4-11 mos): 12-15 hours
- Toddlers (1-2 yrs): 11-14 hours
- Preschoolers (3-5 yrs): 10-13 hours
- School age children (6-13 yrs): 9-11 hours
- Teenagers (14-17 yrs): 8-10 hours
- Younger adults (18-25 yrs): 7-9 hours
- Adults (26-64 yrs): 7-9 hours
- Older adults (65+ yrs): 7-8 hours
To clarify, these ranges are for consolidated periods of sleep (except in the case of children under the age of 6, who usually have multiple sleep periods during the day and night).
Sleep consolidation is key
Consolidated sleep means hours of sleep achieved all at once.
This is important. One cannot expect to just sleep 1 hour at a time, and do that 8 separate times during the day, and expect to achieve all the benefits of adequate sleep.
What researchers understand about sleep duration is influenced by what they also understand about the architecture of sleep. Our sleep stages, phasing, and cycles are part of a complex biological process that requires an uninterrupted stretch of time to be fulfilled, night after night.
While there are outliers who believe it’s healthy to sleep 2 to 3 hours at a time or think it’s harmless to otherwise break up sleep cycles, their theories aren’t generally supported by established science.
Conventional research, on the other hand, generally agrees that human beings should strive to achieve most, if not all, of their sleep in one consolidated period for optimal health.
What causes insufficient sleep?
The causes for not getting enough sleep are many:
- Illness: Anything from the common cold to gout to gastroenteritis to a infections
- Injury: Broken bones, lacerations, deep bruising, burns
- Chronic illness: Autoimmune disorders, cancer, diabetes, heart disease
- Pain disorders: Neuropathy (nerve pain), migraine, arthritis, and other conditions
- Sleep disorders: Insomnia, of course, but also sleep apnea, parasomnia, circadian rhythm disorders, and other conditions
- Mental health disorders: Depression and anxiety, in particular
- Poor sleep hygiene: More problems than can be listed in entirety, but let’s start with cellphone usage in bed, drinking too much coffee, sleeping with the lights on, eating heavy meals late at night, widely varying bedtimes and rise times, and evening “nightcaps” (alcoholic drinks)
- Workplace demands: Business travel, global client meetings at odd hours, shift work, working multiple jobs, overwork, deadline work, long commute times, double shifts
- School demands: Homework (usually in conflict with extracurricular activities like sports or the arts), unreasonably early bell times
- Family demands: Parenting, caregiving, household management, economic demands
- Social life and hobbies: Late night gatherings, video gaming for long periods, television “bingeing,” nocturnal hobbies
Sleep quality matters, too
Some people may get their 7 to 9 hours of sleep every night but still awaken feeling exhausted, in pain, ill, and unrefreshed.
The long list of potential causes for lost sleep points to instances where things like illness or injury or untreated health conditions may be interrupting the opportunity for the brain and body to derive the biological benefits of consolidated sleep.
And here’s the thing: You might not even know it. People who are sleep deprived are typically unaware of the impairment they experience due to loss of sleep.
When you don’t get adequate sleep over long periods of time (days, weeks, months, even years), you are accruing what is known as sleep debt.
Take another look at all the causes for lost sleep listed above. Who hasn’t encountered at least some of these situations? And who among us continues to deal with these situations in a daily basis?
It’s not surprising that 36.5 percent of working Americans are estimated to be sleep deficient (NIOSH, 2019) (Note: the National Safety Council statistics suggest a higher number, at 43 percent). If working Americans are not getting enough sleep—and it’s related to workplace demands alone—it’s a sure sign these people are regularly losing sleep night after night… and adding to sleep debt.
The NHLBI points out that “If a person does not get enough sleep, even on one night, a ‘sleep debt’ begins to build and increases until enough sleep is obtained. Problem sleepiness occurs as the debt accumulates.”
Seriously, it would be better to avoid accumulating sleep debt entirely.
The cost of sleep debt is more than just dark circles
In the working population alone, sleep debt can run afoul of public health and safety. Critical job errors, drowsy driving, absenteeism, lower productivity, equipment accidents, higher workplace dissatisfaction, and chronic illness are some of the long-term outcomes of worker-accrued sleep debt. The National Safety Council now offers a calculator which can measure the actual cost of workplace fatigue, unmasking sleep debt as a potential root cause.
But let’s take it a step further and look at the Princess Cruises “relaxation report” from 2017 (Wakefield Research). Granted, their research is meant to buttress their own marketing efforts to get us all to go on a cruise, but the statistics are still worrisome: Approximately half (49 percent) of Americans surveyed reported they aren’t getting the sleep they need.
And new parents may have it worst of all: new research suggests they can expect to experience disturbed sleep (with sleep deprivation and sleep debt as natural consequences) for as long as 6 years following the birth of a child.
The consequences of sleep deprivation, sleep deficiency, sleep debt, sleep deficit…
No matter what you want to call it, not getting enough sleep on a nightly basis is going to cost you your health and well being. If you carry sleep debt, you are increasing your risk for any of the following:
Lower quality of life
Workplace fatigue, daytime sleepiness, inability to do one’s job safely and up to standard, learning disabilities, memory problems, clumsiness, relationship problems, high-risk behaviors and their consequences (addiction, criminal behavior, unwanted pregnancy), reduced fertility, accelerated aging, reduced libido.